BRAND NAMES
- International: Nevanac ophthalmic suspension: 0.1%
 MECHANISM OF ACTION
Nepafenac is a nonsteroidal anti-inflammatory drug (NSAID) that has anti-inflammatory activity. The mechanism of its action is thought to be due to its ability to block prostaglandin synthesis by inhibiting cyclooxygenase 1 and 2. Prostaglandins have been shown in many animal models to be mediators of certain kinds of intraocular inflammation.
- Treatment of pain and inflammation associated with cataract surgery
One drop of Nepafenac ophthalmic suspension should be applied to the affected eye(s) three-times-daily beginning 1 day prior to cataract surgery, continued on the day of surgery and through the first 2 weeks of the postoperative period
Nepafenac ophthalmic suspension is contraindicated in patients with previously demonstrated hypersensitivity to any of the ingredients in the formula or to other NSAIDS
 WARNINGS AND PRECAUTIONS
Topical nonsteroidal anti-inflammatory drugs (NSAIDs) may slow or delay healing. Topical corticosteroids are also known to slow or delay healing. Concomitant use of topical NSAIDs and topical steroids may increase the potential for healing problems.
Cross-Sensitivity or Hypersensitivity
There is the potential for cross-sensitivity to acetylsalicylic acid, phenylacetic acid derivatives, and other NSAIDs. Therefore, caution should be used when treating individuals who have previously exhibited sensitivities to these drugs.
Increased Bleeding Time
With some NSAIDs, there exists the potential for increased bleeding time due to interference with thrombocyte aggregation. There have been reports that ocularly applied nonsteroidal anti-inflammatory drugs may cause increased bleeding of ocular tissues (including hyphemas) in conjunction with ocular surgery. It is recommended that Nepafenac ophthalmic solution be used with caution in patients with known bleeding tendencies or who are receiving other medications, which may prolong bleeding time.
Use of topical NSAIDs may result in keratitis. In some susceptible patients, continued use of topical NSAIDs may result in epithelial breakdown, corneal thinning, corneal erosion, corneal ulceration, or corneal perforation. These events may be sight threatening. Patients with evidence of corneal epithelial breakdown should immediately discontinue use of topical NSAIDs and should be closely monitored for corneal health.
 PREGNANCY AND LACTATION
- Pregnancy Category C (US). Nepafenac should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
- Nursing Mothers: nepafenac ophthalmic suspension is excreted in the milk of lactating rats. It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when nepafenac ophthalmic suspension is administered to a nursing woman.
 SIDE EFFECTS
Ocular Adverse Reactions
The most frequently reported ocular adverse events following cataract surgery were capsular opacity, decreased visual acuity, foreign body sensation, increased intraocular pressure, and sticky sensation. These events occurred in approximately 5 to 10% of patients.
Other ocular adverse events occurring at an incidence of approximately 1 to 5% included conjunctival edema, corneal edema, dry eye, lid margin crusting, ocular discomfort, ocular hyperemia, ocular pain, ocular pruritus, photophobia, tearing and vitreous detachment.
Some of these events may be the consequence of the cataract surgical procedure.
Non-Ocular Adverse Reactions Non-ocular adverse events reported at an incidence of 1 to 4% included headache, hypertension, nausea/vomiting, and sinusitis.
 RELATED LINKS
|Non-steroidal anti-inflammatory drugs (NSAIDs)|
|Non-selective (COX-1 and COX-2 inhibitors)||Aceclofenac • Acetylsalicylic acid • Benzydamine • Diclofenac • Flurbiprofen • Ibuprofen • Indometacin • Ketoprofen • Ketorolac • Ketorolac • Lornoxicam • Mefenamic acid • Morniflumate • Nabumetone • Naproxen • Niflumic acid • Piroxicam • Tenoxicam|
|Relatively COX-2 selective||Meloxicam • Nimesulide|
|COX-2 selective inhibitors (Coxibs)||Celecoxib • Etoricoxib • Parecoxib|
|Ophthalmic NSAIDs||Bromfenac (ophthalmic) • Diclofenac (ophthalmic) • Flurbiprofen (ophthalmic) • Ketorolac (ophthalmic) • Nepafenac (ophthalmic)|
|Veterinary use||Carprofen • Deracoxib • Firocoxib • Mavacoxib • Robenacoxib|